Deconstructing triglyceride glucose-body mass index in normal-weight women with polyendocrine metabolic ovarian syndrome.

OBJECTIVE

To study the biological pathways underlying the triglyceride glucose-body mass index (TyG-BMI), calculated as natural logarithm (plasma triglyceride [mg/dL] × fasting blood glucose [mg/dL]/2) × body mass index (BMI), in normal-weight women with polyendocrine metabolic ovarian syndrome (PMOS) and age-/BMI-matched normoandrogenic ovulatory (control) women, and to determine whether the TyG-BMI in such women is a useful clinical predictor of reduced in vitro fertilization (IVF) pregnancy outcome.

DESIGN

Retrospective cohort study SUBJECTS: Twenty-one normal-weight women with PMOS and 19 age- and BMI-matched controls.

EXPOSURE: All women underwent fasting circulating metabolic/androgenic determinations.

MAIN OUTCOME MEASURES: The TyG-BMI was compared between women with PMOS and age-/BMI-matched controls and correlated with metabolic/androgenic outcomes.

RESULTS

Serum luteinizing hormone/androgen levels and fasting serum triglyceride/insulin levels were significantly greater in women with PMOS than controls. Adipose insulin resistance (adipose-IR) was also increased in women with PMOS vs. controls. The TyG-BMI and homeostasis model assessment of insulin resistance, however, were not significantly different by female type. In multivariable linear regression, TyG-BMI was unassociated with PMOS, serum free testosterone or fasting serum insulin levels. Instead, in all women combined, higher TyG-BMI levels were associated with greater adipose-IR, higher serum non-high-density lipoprotein cholesterol, and lower serum high-density lipoprotein cholesterol levels.

CONCLUSION

Adipose-IR accompanying altered lipid metabolism underlies the TyG-BMI of normal-weight women with PMOS and age-/BMI-matched controls. The TyG-BMI, however, may have limited utility in predicting reduced IVF pregnancy outcome in normal-weight women with PMOS, although confirmation in similar cohorts undergoing IVF is needed.